Individual
MRS. CONSTANCE M BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
314 MAIN STREET, SUITE B, MONTICELLO, MS 39654
(601) 393-1953
(601) 393-1954
Mailing address
314 MAIN STREET, SUITE B, MONTICELLO, MS 39654
(601) 393-1953
(601) 393-1954
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R878491
MS
363LF0000X
Family Nurse Practitioner
Primary
878491
MS
363LF0000X
Family Nurse Practitioner
R878491
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01980539
—
MS
Enumeration date
01/22/2007
Last updated
10/03/2023
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